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NPI Code Detail

MEDICARE: MR. RICHARD JOSEPH KEIM JR. PA-C

MEDICARE: MR. RICHARD JOSEPH KEIM JR. PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA-250ME
2363AM0700XMedical Physician AssistantPA02081TX

General Provider Information

NPI Number : 1548251523
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICHARD JOSEPH KEIM JR. PA-C
Provider Business Mailing Address
First Line : 9080 MARBACH RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78245-1810
Country : US
Telephone Number : 210-436-8400
Fax Number : 833-452-1052
Provider Business Practice Location Address
First Line : 9080 MARBACH RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78245-1810
Country : US
Telephone Number : 210-436-8400
Fax Number : 833-452-1052
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 01/27/2023

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